Clinical Approaches to Reducing Material Hardship Due to Poverty: Social Risks/Needs Identification and Interventions.
Clinical Approaches to Reducing Material Hardship Due to Poverty: Social Risks/Needs Identification and Interventions.
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DOI：
10.1016/j.acap.2021.02.007
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发表时间：
2021-11-01
影响因子：
3.1
通讯作者：
Fiori, Kevin P
中科院分区：
文献类型：
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作者：
Garg, Arvin;Brochier, Annelise;Fiori, Kevin P
儿科领域率先采取了减轻贫穷对儿童健康和发展的有害影响的办法。然而，在儿科护理提供方面，系统地解决贫困造成的物质困难的临床干预措施仍处于起步阶段。自美国儿科学会于2016年发布关于美国儿童健康和贫困的政策声明以来，人们对系统识别和解决社会风险和/或社会需求的护理模式的开发和实施的兴趣激增。本文探讨了这一重大转变的兴趣，研究和投资，在儿科护理等干预措施。我们提供了一个概述，目前的筛选和转诊模式，以解决贫困相关的社会因素，并探讨这些不同的方法的优点和缺点。我们总结了目前支持这种临床方法的证据，并评论了多部门合作伙伴关系在满足家庭和社区需求方面的重要性。最后，我们提出了研究和儿科实践的未来方向，可能会提高社会风险/需求干预措施的吸收，并加强其有效性的证据。虽然解决物质困难的临床方法可能受到社会安全网不足和其他障碍的限制，但确定和解决家庭社会风险和社会需求的干预措施有可能消除贫穷对儿童的影响，促进保健公平。
The field of pediatrics has pioneered approaches to mitigating poverty's harmful effects on children's health and development. Clinical interventions for systematically addressing material hardships due to poverty within the context of pediatric care delivery, however, are still in their infancy. Since the American Academy of Pediatrics published its policy statement on Child Health and Poverty in the United States in 2016, interest has surged in the development and implementation of care models that systematically identify and address social risks and/or social needs. This article explores this major shift in interest, research, and investment in such interventions within pediatric care. We provide an overview of current screening and referral models for addressing poverty-related social factors and explore the strengths and weaknesses of these varied approaches. We summarize the current evidence supporting such clinical approaches, and comment on the importance of multi-sectoral partnerships in addressing families' and communities' needs. Lastly, we propose future directions for research and pediatric practice that may enhance the uptake of social risks/needs interventions and bolster the evidence of their effectiveness. Though clinical approaches for addressing material hardship may be limited by an insufficient social safety net and other barriers, interventions to identify and address families' social risks and social needs have the potential to combat poverty's impact on children and advance health equity.